Individual provider Active NPI

Tina M Galordi, PSYD

  • Clinical Psychologist
  • San Rafael, CA
National Provider Identifier
1871135665
Registry record updated Oct 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
27805 Issued in CA
Practice address
1414 4TH St Ste 201
San Rafael, CA 94901-2857
Phone
(415) 269-3657
NPI assigned
Oct 13, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 27805 CA Primary

Addresses

Primary practice location

1414 4TH St Ste 201
San Rafael, CA 94901-2857

Mailing address

1414 4TH St Ste 201
San Rafael, CA 94901-2857
Phone (415) 269-3657

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
27805CAMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570924800000",
    "number": "1871135665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 4TH ST STE 201",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012857",
            "telephone_number": "415-269-3657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 4TH ST STE 201",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012857",
            "telephone_number": "415-269-3657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALORDI",
        "first_name": "TINA",
        "middle_name": "M",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-13",
        "last_updated": "2019-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "27805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.